Do I have tubular breasts and is surgery the solution? (Photos)

I've always thought my breasts as underdeveloped. I'm now 23 and my double A cup size and "puffy" nipples make that assumption stronger. What could be my diagnosis and what are some options for dealing with this condition? If surgery is needed, it would be great to suggestions for the best type, longer lasting, etc. Thank you.

Doctor Answers 10

Do I have tubular breasts and is surgery the solution?

I am happy to say that you do not have tuberous breasts. There is a very slight constriction beneath the areola.  However breast augmentation with implants should give you a very nice result with fuller breasts and a better breast shape.  I would certainly wait to see if you need a periareolar incision until 6 months after breast augmentation.  Based on your photographs alone my suspicion is that she will not need any excision of skin beneath the areola.  Please see an experienced board certified plastic surgeon.

Do I have tubular breasts and is surgery the solution?

If you breasts are tubular, it is very minor and they look within the normal range of breast. If you desire larger breasts, than an implant would be appropriate. Otherwise, I would not do anything. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 62 reviews

Breast Augmentation

Hi Nycecogirl,I agree with Dr. Wallach below.  You just have a touch of Tuberous Breasts, with some nipple herniation.  I believe you will look great.  I have prepared a video link you can click on above and below I put a link to a journal article explaining how we recommend the dual plane BA for TB.  Enjoy!  All the best, Dr. Joe

Breast issue

If you want larger breasts, then implants can help. You may also need a circumareola approach to reduce the size of the areola and control any puffiness or herniation. Best to be seen in person.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Breast Augmentation/Breast Implants/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision

I appreciate your question. From your photos, you do appear to have characteristics of tuberous breasts. Constricted or tubular breasts tend to be too narrow with a breast crease that is too high. Tight ring-like bands of tissue around the areolae and nipples may create the appearance of protruding or puffy areolae. A higher than normal breast crease may make your nipples appear to be too low or down pointing. Constricted breast features can be very mild or severe. In fact, mild variations are relatively common. To summarize, the features can include:
  •          Inframammary fold (breast crease) too high
  •          Inframammary fold misshapen
  •          Breasts too narrow (disproportionately narrow base width)
  •          Insufficient breast skin
  •          Constricted or tubular shape, resulting from tight bands of tissue within breasts
  •          Protruding or bulging appearance of areolae (pigmented area around nipples)
Improvement is possible and generally includes a breast augmentation, sometimes combined with a lift (mastopexy). The lift is usually limited to an incision around the areolae. During the procedure, I release the tight, constricting bands from the inside, allowing the skin to expand properly. I also lower the inframammary fold to a more ideal position and improve its shape. Breast implants help create the right amount of volume and improve breast contours, resulting in a more rounded or tear drop shape. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative plastic surgery.Best of luck! Dr. Schwartz Board Certified Plastic Surgeon Director-Beverly Hills Breast and Body Institute #RealSelf100Surgeon #RealSelfCORESurgeon

Breast size

The real question is whether or not your breasts bother you. Tubular breast is a benign condition that does not need to be "fixed." If you desire bigger breasts then I would recommend consulting with a board certified plastic surgeon in your area. They will be able to address your concerns and provide you with some options.

Asaf Yalif, MD
Roswell Plastic Surgeon
5.0 out of 5 stars 6 reviews

Do I have tubular breasts and is surgery the solution?

It appears that you have a slight amount of breast tissue under the areola. The bigger question is: Are you satisfied with your size? If not, and you wish to be larger- then you appear to be an excellent candidate for Breast Augmentation. Your condition is not that uncommon- and here's a link to a similar case - similar: 


You have mild tubular breasts thst will do perfectly well with dual plane breast implant placement. Seek breast specialist in your area and best of luck

Stuart A. Linder, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 40 reviews

Do I have tubular breasts and is surgery the solution?

Thank you for the question and pictures. 
I think your breast photos do demonstrate some of the characteristics seen with tuberous (constricted) breasts. For example, the distance from the areola to inframammary folds seems to be tight and relatively short. Your inframammary folds seem to be widely spaced from the midline of your chest. The areola do demonstrate some features associated with tubular breast such as an increased width and “puffiness”.

Generally, correction of tuberous breast anomalies involves breast augmentation with areola reduction / mastopexy procedure. The distance from the inframammary fold is increased (to create a more rounded out appearance). Proper implant positioning improves the distance (cleavage) between the breasts. The areola reduction helps to treat the pointed and "puffy" appearance of the areola.

In your case, if the appearance/shape/size of the breasts are a concern, you may be an excellent candidate for corrective surgery. In my practice, I would certainly recommend the use of silicone gel breast implants placed in the sub muscular (dual plane) position.   

When you are ready, please make sure you consult with well experienced board-certified plastic surgeons who have significant (demonstrable) experience with this type of surgery. There are a lot of factors to consider when making recommendations; for example your life circumstances ( planned pregnancies, psychosocial situation…) and tolerance for scars are factors that should be taken into consideration by you and your plastic surgeon.

  The good news:  in our practice, some of our happiest patients have been patients who have started out with constricted/tuberous breasts. I hope this, and the attached link (dedicated to corrective surgery for patients with tuberous/constricted breasts) helps.

Tuberous breasts

Tuberous breasts occur when skin of the lower portion of the breasts is excessively tight during development, creating high, small, widely spaced breasts that can herniate through the areolas causing a pointy overall appearance with protrusion of the areolas.  Tuberous breasts are seen on a spectrum with very mild to very severe cases.It is difficult to say with certainty if you have a mild spectrum tuberous breast condition versus simply smaller breasts with mildly protruding areolas.  The lower curve of your breasts don't look particularly constricted in the photos and your breasts have a very reasonable shape and proportion.That being said, if you wish to change your breasts, you are a very reasonable candidate for surgery.  Breast augmentation with appropriately sized implants would improve the fullness and shape of the breasts overall.  If you wanted to address the protrusion of the areolas, you could consider a tightening around the edge of the areolas (circumareolar mastopexy).  This would flatten and reduce the areola sizes, but would require a scar all the way around the edge of the areolas. I highly doubt you would need any of the internal glandular tissue scoring needed to correct true tuberous breasts.  Since your issues are mild, you should think about what your priorities are and meet with a few board certified plastic surgeons to discuss options in person.  Good luck!

Robert Cohen, MD
Santa Monica Plastic Surgeon
5.0 out of 5 stars 39 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.